Objective: In comparison to traditional treatment options, TNF-á inhibitors have shown promise in increasing the clearance of psoriatic lesions and improving the quality-of-life of patients with moderate-to-severe psoriasis. They are however associated with higher costs and side-effects. The study objective was to compare the cost-effectiveness of TNF-á inhibitors to other psoriasis treatment strategies. Methods: The cost-effectiveness of ten treatment options from three drug classes- TNF- á inhibitors, systemic therapies and phototherapy- were evaluated using a decision analysis model constructed using DATA Treeage. The probabilities of success were obtained from PASI-75 scores from published clinical trials. The annual drug costs were obtained from the Drug Topics Red Book and published clinical trials. Additional costs associated with treatment, which included annual pharmacy costs and costs for professional and institutional services, were obtained from published reports. Incremental cost effectiveness ratios (ICERs) were calculated for additional cost divided by incremental PASI-75 values, and were estimated relative to the drug with the lowest cost. Multiple sensitivity analyses were performed to determine the robustness of the findings. Results: Phototherapy was found to be the most cost-effective treatment option with an ICER of $16,435.89/PASI-75, relative to systemic therapy. The most cost-effective TNF-á inhibitor was infliximab, with an ICER of $15,733/PASI-75, relative to adalimumab. Infliximab had the highest drug acquisition cost ($21,250) among the 10 treatment strategies. While Goekerman therapy with a PASI-75 score of 100 had the highest clinical effectiveness among all the treatment strategies examined, the more effective TNF-á inhibitor was infliximab, with a PASI-75 score of 82.3. Sensitivity analysis indicated that the results were affected by the model assumptions. Conclusion: Thus, phototherapy was found to be the more cost-effective treatment option in this analysis. It is expected that the cost of TNF-á inhibitors will be lower in the future.